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https://www.readbyqxmd.com/read/27902542/impact-of-mental-health-comorbidities-on-the-community-based-pediatric-treatment-and-outcomes-of-children-with-attention-deficit-hyperactivity-disorder
#1
Nour Al Ghriwati, Joshua M Langberg, William Gardner, James Peugh, Kelly J Kelleher, Rebecca Baum, William B Brinkman, Phil Lichtenstein, Jeffery N Epstein
OBJECTIVE: Children with attention deficit hyperactivity disorder (ADHD) often exhibit psychiatric comorbidities, which may impact illness presentation, diagnosis, and treatment outcomes. Guidelines exist for dealing with these complex cases but little is known about how comorbidities are being handled in community pediatric settings. The purpose of this study was to evaluate how mental health comorbidities affect community physicians' ADHD care practices and patients' symptom trajectories...
November 23, 2016: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#2
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
https://www.readbyqxmd.com/read/27898628/fracture-and-nonaccidental-injury-a-case-report-of-a-lateral-condylar-fracture-in-a-13-month-old
#3
Helen Levin, Gurinder Sangha, Timothy P Carey, Rodrick Lim
Pediatric nonaccidental injury (NAI) is an important entity that is commonly seen in a variety of medical settings. These children often present to the emergency department or primary care physicians as the first point of contact after an NAI. There is a major risk associated with nonrecognition of an NAI, including a 35% chance of subsequent injury and a 5% to 10% risk of mortality. Therefore, it is essential for physicians to be vigilant when assessing injuries compatible with NAI, especially in infants and young children who are not able to independently express themselves...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27898626/dental-trauma-in-a-pediatric-emergency-department-referral-center
#4
Emily Hall, Patricia Hickey, Thuy Nguyen-Tran, Jeff Louie
OBJECTIVE: The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department. METHODS: We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27893197/importance-to-question-sinonasal-symptoms-and-to-perform-rhinoscopy-and-rhinomanometry-in-cystic-fibrosis-patients
#5
J M Bock, M Schien, C Fischer, L Naehrlich, M Kaeding, O Guntinas-Lichius, A Gerber, C Arnold, J G Mainz
OBJECTIVES: Cystic fibrosis (CF) patients almost regularly reveal sinonasal pathology. The purpose of this study was to assess association between objective and subjective measurements of sinonasal involvement comparing nasal airflow obtained by active anterior rhinomanometry (AAR), nasal endoscopic findings, and symptoms assessed with the Sino-Nasal Outcome Test-20 (SNOT-20). METHODS: Nasal cavities were explored by anterior rigid rhinoscopy and findings were compared to inspiratory nasal airflow measured by AAR to quantify nasal patency and subjective health-related quality of life in sinonasal disease obtained with the SNOT-20 questionnaire...
November 28, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27890530/provider-perspectives-on-adding-biomarker-screening-for-tobacco-smoke-exposure-to-lead-screening-at-well-child-visits
#6
Winta Ghidei, Gail Brottman, Eline Lenne, Tukhanh Quan, Anne Joseph
INTRODUCTION: Measurement of cotinine, a biomarker of tobacco smoke exposure, can accurately identify children at risk of health consequences from secondhand smoke. This study reports perspectives from pediatric health care providers on incorporating routine cotinine screening into well-child visits. METHODS: Key informant interviews (N = 28) were conducted with pediatric primary care providers: physicians, nurse practitioners, and registered nurses. RESULTS: Themes identified in the interviews included the following: (a) Cotinine screening would assess children's exposure to tobacco smoke more reliably than parental report; (b) Addressing positive cotinine screening results might require additional resources; (c) Wheezing and a history of emergency department visits increased the salience of cotinine screening; and (d) A better understanding of the significance of specific cotinine test values would improve utility...
November 24, 2016: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/27887795/clinician-knowledge-clinician-barriers-and-perceived-parental-barriers-regarding-human-papillomavirus-vaccination-association-with-initiation-and-completion-rates
#7
Lila J Finney Rutten, Jennifer L St Sauver, Timothy J Beebe, Patrick M Wilson, Debra J Jacobson, Chun Fan, Carmen Radecki Breitkopf, Susan T Vadaparampil, Robert M Jacobson
PURPOSE: We tested the hypothesis that clinician knowledge, clinician barriers, and perceived parental barriers relevant to the human papillomavirus (HPV) vaccination account for the variation in vaccine delivery at the practice-site level. METHODS: We conducted a survey from October 2015 through January 2016 among primary care clinicians (n=280) in a 27-county geographic region to assess clinician knowledge, clinician barriers, and perceived parental barriers regarding HPV vaccination...
November 23, 2016: Vaccine
https://www.readbyqxmd.com/read/27887664/translating-sickle-cell-guidelines-into-practice-for-primary-care-providers-with-project-echo
#8
Lisa M Shook, Christina B Farrell, Karen A Kalinyak, Stephen C Nelson, Brandon M Hardesty, Angeli G Rampersad, Kay L Saving, Wanda J Whitten-Shurney, Julie A Panepinto, Russell E Ware, Lori E Crosby
BACKGROUND: Approximately 100,000 persons with sickle cell disease (SCD) live in the United States, including 15,000 in the Midwest. Unfortunately, many patients experience poor health outcomes due to limited access to primary care providers (PCPs) who are prepared to deliver evidence-based SCD care. Sickle Treatment and Outcomes Research in the Midwest (STORM) is a regional network established to improve care and outcomes for individuals with SCD living in Indiana, Illinois, Michigan, Minnesota, Ohio, and Wisconsin...
2016: Medical Education Online
https://www.readbyqxmd.com/read/27884013/guidelines-for-growth-hormone-and-insulin-like-growth-factor-i-treatment-in-children-and-adolescents-growth-hormone-deficiency-idiopathic-short-stature-and-primary-insulin-like-growth-factor-i-deficiency
#9
Adda Grimberg, Sara A DiVall, Constantin Polychronakos, David B Allen, Laurie E Cohen, Jose Bernardo Quintos, Wilma C Rossi, Chris Feudtner, Mohammad Hassan Murad
BACKGROUND/AIMS: On behalf of the Drug and Therapeutics, and Ethics Committees of the Pediatric Endocrine Society, we sought to update the guidelines published in 2003 on the use of growth hormone (GH). Because idiopathic short stature (ISS) remains a controversial indication, and diagnostic challenges often blur the distinction between ISS, GH deficiency (GHD), and primary IGF-I deficiency (PIGFD), we focused on these three diagnoses, thereby adding recombinant IGF-I therapy to the GH guidelines for the first time...
November 25, 2016: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/27882294/cough-and-fever-in-an-immigrant-adolescent-with-abnormal-chest-x-ray
#10
Nicole Giles, Rajeev Bhatia
Tuberculosis (TB) remains a leading cause of death from infectious disease worldwide with 80,000 pediatric deaths annually. Disease caused by Mycobacterium tuberculosis (Mtb) is usually asymptomatic in pediatric patients and resolves after completion of standard therapy with isoniazid (INH). Rare reports document children greater than 10 years of age in endemic regions developing adult type cavitary disease, an infectious pulmonary tuberculosis lesion. This is a notable case of post-infectious pulmonary TB disease with adult type cavitation in an immigrant adolescent, which developed even after completing standard therapy with INH...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27881828/-hope-for-the-best-prepare-for-the-worst-a-qualitative-interview-study-on-parents-needs-and-fears-in-pediatric-advance-care-planning
#11
Julia Desiree Lotz, Marion Daxer, Ralf J Jox, Gian Domenico Borasio, Monika Führer
BACKGROUND: Pediatric advance care planning is advocated by healthcare providers because it may increase the chance that patient and/or parent wishes are respected and thus improve end-of-life care. However, since end-of-life decisions for children are particularly difficult and charged with emotions, physicians are often afraid of addressing pediatric advance care planning. AIM: We aimed to investigate parents' views and needs regarding pediatric advance care planning...
November 23, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/27880811/oral-ondansetron-versus-domperidone-for-acute-gastroenteritis-in-pediatric-emergency-departments-multicenter-double-blind-randomized-controlled-trial
#12
Federico Marchetti, Maurizio Bonati, Alessandra Maestro, Davide Zanon, Francesca Rovere, Alberto Arrighini, Egidio Barbi, Paolo Bertolani, Paolo Biban, Liviana Da Dalt, Andrea Guala, Elisa Mazzoni, Anna Pazzaglia, Paolo Francesco Perri, Antonino Reale, Salvatore Renna, Antonio Francesco Urbino, Enrico Valletta, Antonio Vitale, Tiziana Zangardi, Antonio Clavenna, Luca Ronfani
The use of antiemetics for vomiting in acute gastroenteritis in children is still a matter of debate. We conducted a double-blind randomized trial to evaluate whether a single oral dose of ondansetron vs domperidone or placebo improves outcomes in children with gastroenteritis. After failure of initial oral rehydration administration, children aged 1-6 years admitted for gastroenteritis to the pediatric emergency departments of 15 hospitals in Italy were randomized to receive one oral dose of ondansetron (0...
2016: PloS One
https://www.readbyqxmd.com/read/27880049/understanding-clinicians-attitudes-toward-a-mobile-health-strategy-to-childhood-asthma-management-a-qualitative-study
#13
Jessica P Hollenbach, Anna Cushing, Emilie Melvin, Bryanna McGowan, Michelle M Cloutier, Melissa Manice
OBJECTIVES: Mobile technology for childhood asthma can provide real-time data to enhance care. What real-time adherence information clinicians want, how they may use it, and if the data meet their clinical needs has not been fully explored. Our goal was to determine whether pediatric primary care and pulmonary clinicians believe a sensor-based mobile intervention is useful in caring for patients with asthma. METHODS: We recruited participants from 3 urban, primary care and 1 pulmonary practice from July to September 2015 in Hartford, CT...
November 23, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27879297/addressing-the-mental-health-needs-of-latino-children-in-immigrant-families
#14
Tania Maria Caballero, Lisa Ross DeCamp, Rheanna E Platt, Harita Shah, Sara B Johnson, Erica M S Sibinga, Sarah Polk
Latino children in the United States, whether immigrants themselves or children in immigrant families, are at high risk for mental health disorders stemming from poverty, exposure to trauma, assimilation stressors, and discrimination. The timely identification and treatment of mental health disorders in Latino children are compromised by limited healthcare access and quality as well as the lack of routine mental health screening in pediatric primary care. Here we review Spanish-language validity and implementation studies of Bright Futures previsit mental health screening tools and models of care...
November 21, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27878830/clinical-assessment-of-histidine-tryptophan-ketoglutarate-solution-and-modified-st-thomas-solution-in-pediatric-cardiac-surgery-of-tetralogy-of-fallot
#15
Zhao-Hui Wang, Yong An, Ming-Cheng Du, Ting-Jiang Qin, Yin-Bei Liu, Hong-Zhen Xu, Li-Qun Yang
The objective of this study is to compare the myocardium protective effect of Bretschneider's histidine-tryptophan-ketoglutarate (HTK) solution versus Modified St. Thomas' (STH) solution in pediatric cardiac surgery of Tetralogy of Fallot (TOF). Seventy-seven pediatric patients of TOF who received the total surgical repair were reviewed, from January 2014 to October 2015. A horizontal comparison between HTK solution and modified STH solution has been made since the HTK solutions were started to be used in our hospital...
November 22, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27878782/trajectory-of-cause-of-death-among-brought-dead-neonates-in-tertiary-care-public-facilities-of-pakistan-a-multicenter-study
#16
Muhammad Ayaz Mustufa, Munir Ahmed Sheikh, Ijaz-Ul-Haque Taseer, Syed Jamal Raza, Muhammad Sohail Arshad, Tasleem Akhter, Ghazala Mohyuddin Arain, Sultana Habibullah, Sohail Safdar, Rukhsana Firdous, Muhammad Adnan
BACKGROUND: Considering the fact that Pakistan is amongst the countries with very high neonatal mortality rates, we conducted a research study to determine the possible causes and characteristics of neonates presenting dead to the emergency department of tertiary public health care facilities of Pakistan using verbal autopsies. METHODS: A descriptive case series study was conducted in emergency department/pediatrics ward/neonatal ward/nursery unit of ten tertiary care public health facilities, situated in seven major cities of Pakistan from November, 2011 to June, 2013...
November 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27876588/predicting-subsequent-high-frequency-low-acuity-utilization-of-the-pediatric-emergency-department
#17
Margaret E Samuels-Kalow, Matthew W Bryan, Kathy N Shaw
OBJECTIVE: To derive and test a predictive model for high-frequency (>= four visits/year), low-acuity (Emergency Severity Index 4 or 5) utilization of the pediatric emergency department. METHODS: The study sample used three years of data (2012-14) from a single tertiary care children's hospital for patients <21 years of age. Utilization in 2013 defined the index visit; prior utilization was drawn from 2012; and 2014 was used for outcome measurement. Candidate predictor variables were those that would be available at the time of triage...
November 19, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27876084/a-trial-to-determine-whether-septic-shock-reversal-is-quicker-in-pediatric-patients-randomized-to-an-early-goal-directed-fluid-sparing-strategy-versus-usual-care-squeeze-study-protocol-for-a-pilot-randomized-controlled-trial
#18
Melissa J Parker, Lehana Thabane, Alison Fox-Robichaud, Patricia Liaw, Karen Choong
BACKGROUND: Current pediatric septic shock resuscitation guidelines from the American College of Critical Care Medicine focus on the early and goal-directed administration of intravascular fluid followed by vasoactive medication infusions for persistent and fluid-refractory shock. However, accumulating adult and pediatric data suggest that excessive fluid administration is associated with worse patient outcomes and even increased risk of death. The optimal amount of intravascular fluid required in early pediatric septic shock resuscitation prior to the initiation of vasoactive support remains unanswered...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27876028/clinical-assessment-of-children-with-renal-abscesses-presenting-to-the-pediatric-emergency-department
#19
Chun-Yu Chen, Huang-Tsung Kuo, Yu-Jun Chang, Kang-Hsi Wu, Wen-Chieh Yang, Han-Ping Wu
BACKGROUND: Renal abscesses are relatively uncommon in children but may result in prolonged hospital stays and life-threatening events. We undertook this study to analyze the clinical spectrum of renal abscesses in children admitted to the pediatric emergency department (ED) and to find helpful clinical characteristics that can potentially aid emergency physicians for detecting renal abscesses in children earlier. METHODS: From 2004 to 2011, we retrospectively analyzed 17 patients, aged 18 years or younger, with a definite diagnosis of renal abscess admitted to the ED...
November 22, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27870384/high-flow-nasal-cannula-use-outside-of-the-icu-factors-associated-with-failure
#20
Kristina A Betters, Scott E Gillespie, Judson Miller, David Kotzbauer, Kiran B Hebbar
OBJECTIVES: High flow nasal cannula (HFNC) use is increasing in pediatrics. Few studies exist examining the safety of HFNC use outside the intensive care unit (ICU). This study aimed to characterize patient qualities associated with failure of HFNC use outside the ICU. STUDY DESIGN: A retrospective chart review of patients placed on HFNC outside the ICU from September 2011 to July 2013 was completed. Failure was defined as intubation or cardiopulmonary arrest. Two-sample tests and binary logistic regression determined significant factors associated with failed HFNC administration, both unadjusted and adjusted for hospital...
November 21, 2016: Pediatric Pulmonology
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